男性性工作者HIV暴露后预防用药情况及相关因素分析  

Uptake of HIV post-exposure prophylaxis and related factors in male sex workers

作　　者：张奥迪 杨柏林 尹寒露 顾静[2] 陈积标 许祝平 孟晓军 Zhang Aodi;Yang Bolin;Yin Hanlu;Gu Jing;Chen Jibiao;Xu Zhuping;Meng Xiaojun(School of Public Health,Nanjing Medical University,Nanjing 211166,China;The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学公共卫生学院,南京211166 [2]南京医科大学附属无锡疾病预防控制中心,无锡214023

出　　处：《中华流行病学杂志》2024年第8期1158-1163,共6页Chinese Journal of Epidemiology

基　　金：无锡市科技局项目(Y20222006);无锡市卫生健康委项目(BJ2023097)。

摘　　要：目的了解男性性工作者(MSW)HIV暴露后预防(PEP)用药情况及相关因素,为推广PEP提供参考。方法2023年10月在江苏省无锡市通过MSM社会组织的协助,选取MSW活动的娱乐场所,采用方便抽样的方法招募MSW为研究对象,开展横断面调查,样本量估计为340人。问卷调查收集研究对象的社会人口学特征、性行为特征和PEP知识、信念和行为等信息。采用logistic回归模型分析影响MSW使用PEP药物的相关因素。应用SPSS 26.0软件进行统计学分析。结果MSW共357人,以18~20岁(55.7%,199/357)、未婚(94.4%,337/357)、初中/中专及以下文化程度(50.1%,179/357)为主。知道PEP的占64.4%(230/357),相信PEP的占51.0%(182/357),PEP用药率为13.4%(48/357),最近3个月发生高危性行为者的PEP用药率为17.6%(12/68)。多因素logistic回归分析结果显示,最近3个月与男性发生群交(aOR=7.51,95%CI:1.37~41.09)、做过HIV检测(aOR=2.89,95%CI:1.16~7.16)、使用暴露前预防药物(aOR=30.18,95%CI:12.60~72.24)和相信PEP药物阻断作用(aOR=2.94,95%CI:1.04~8.29)是MSW的PEP用药相关因素。结论MSW的PEP用药率较高,但最近3个月发生高危性行为者的PEP用药率仍然较低。因此需结合该人群特点,加强HIV风险认知教育,促进其发生高危性行为后及时通过PEP药物阻断HIV传播。Objective To understand the uptake of post-exposure prophylaxis(PEP)and related factors among male sex workers(MSW)and provide references for the promotion of PEP.Methods A cross-sectional study was conducted using convenience sampling to recruit MSW participants with the help of a community-based organization in October 2023,in Wuxi City,Jiangsu Province.The sample size was estimated at 340 people.A self-administered questionnaire was used to collect their social demographic characteristics,sexual behaviors,knowledge,beliefs,and uptake of PEP.A logistic regression model was used to analyze factors associated with the uptake of PEP in MSW.The SPSS 26.0 software was used for statistical analysis.Results A total of 357 participants were recruited,mainly aged 18-20(55.7%,199/357),unmarried(94.4%,337/357),and having an education background of junior high school or below(50.1%,179/357).Among 357 participants,64.4%(230/357)knew about PEP,51.0%(182/357)believed in the efficacy of PEP,and 13.4%(48/357)had experience of using PEP.Among 68 respondents having high-risk sexual behaviors in the past 3 months,17.6%(12/68)have had uptake of PEP.Multivariable logistic regression analysis showed that group sex with men in the past 3 months(aOR=7.51,95%CI:1.37-41.09),HIV testing in the past 3 months(aOR=2.89,95%CI:1.16-7.16),the experience of using pre-exposure prophylaxis(aOR=30.18,95%CI:12.60-72.24)and believing in the efficacy of PEP(aOR=2.94,95%CI:1.04-8.29)were the associated factors with the uptake of PEP in MSW.Conclusions Although the overall uptake rate of PEP in MSW was high,the proportion of using PEP was still low among participants having high-risk sexual behaviors in the past 3 months.Therefore,it is necessary to strengthen HIV risk awareness education considering their characteristics and promote timely uptake of PEP to interrupt HIV transmission.

关 键 词：艾滋病病毒 男性性工作者 暴露后预防 相关因素 

分 类 号：R512.91[医药卫生—内科学]